Issues Close to Home: Establishing a Separate Benefit Category for Complex Rehab Technology

A critical issue in the paralysis community is coverage for Complex Rehabilitation Technologies (CRT). CRT consists of medically necessary and individually configured products and services designed to meet the unique medical and functional needs of individuals, allowing individuals with disabilities to achieve high levels of function and good health outcomes, as well as participate independently in their community.

Unfortunately, CRT is currently coupled with the more general Durable Medical Equipment (DME) benefit. This results in patients facing a series of challenges when trying to access the appropriate and necessary technologies and services.

Medicare's DME benefit was drafted over 40 years ago, well before the advances in technology. Over the years, durable medical equipment (DME) has become customized and unique to the user and specific disability. The Medicare guidelines have not changed with technology. By creating a separate category under Medicare for CRT, the specific and unique equipment needs of individuals with disabilities can be met. This will account for only 7% of all equipment needs.

The Reeve Foundation supports a new category for CRT under the Medicare Durable Medical Equipment (DME) benefit, and in April, Representative Joseph Crowley of New York introduced H.R. 4378 "Ensuring Access to Quality Complex Rehabilitation Technology Act."

This legislation addresses existing challenges by:

Ensuring access to appropriate products and technology based on a person's functional needs, rather than diagnosis;

Allowing individuals to access devices that can be used outside of the home and in the community, allowing individuals to work and participate in community life; and

Ensuring access to local CRT suppliers equipped to make repairs and maintenance for specialized devices.

As this legislation moves forward, we will be updating you on how to contact your Member of Congress in support of this important legislation.